Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.
BK21 FOUR Education and Research Team for Sustainable Food and Nutrition, Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
Eur J Nutr. 2022 Mar;61(2):925-933. doi: 10.1007/s00394-021-02700-2. Epub 2021 Oct 17.
We examined post-diagnostic diet quality in relation to all-cause and cancer-specific mortality among adults diagnosed with invasive cancer between cohort entry (45-75 years) and their 10-year follow-up, in comparison with those without invasive cancer during that period, in the Multiethnic Cohort.
Data were from 70,045 African Americans, Native Hawaiians, Japanese Americans, Latinos, and Whites (6370 with cancer, 63,675 without cancer). Diet quality was measured by the Healthy Eating Index (HEI)-2015, the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED), and the Dietary Approaches to Stop Hypertension (DASH) scores, using a food frequency questionnaire. Multivariable Cox models estimated the association of the dietary indexes at 10-year follow-up and changes since baseline with subsequent mortality.
Post-diagnostic scores from all four indexes were associated with lower mortality: for the highest vs. lowest quartiles, hazard ratio (HR) for all-cause mortality was 0.74 (95% CI 0.67-0.82) for HEI-2015, 0.82 (0.74-0.92) for AHEI-2010, 0.74 (0.66-0.84) for aMED, and 0.82 (0.74-0.91) for DASH. The corresponding HRs for cancer mortality were 0.84 (0.71-1.00), 0.85 (0.71-1.00), 0.71 (0.59-0.85), and 0.84 (0.71-1.00). Compared to stable scores over 10 years (< 0.5 SD change), HR for all-cause mortality was 0.87 (0.79-0.97) for ≥ 1 SD increase in HEI-2015 and was 1.22 to 1.29 for ≥ 1 SD decrease in scores across the four indexes. These HRs were similar to those for participants without cancer.
Post-diagnostic high-quality diet was related to lower all-cause and cancer mortality among adult cancer survivors, with risk reduction comparable to that among participants without cancer.
我们研究了在多民族队列中，与同期未患浸润性癌症的个体相比，在队列入组（45-75 岁）至 10 年随访期间被诊断为浸润性癌症的成年人在诊断后的饮食质量与全因和癌症特异性死亡率之间的关系。
本研究的数据来自 70045 名非裔美国人、夏威夷原住民、日裔美国人、拉丁裔和白人（6370 名癌症患者，63675 名非癌症患者）。通过食物频率问卷，使用健康饮食指数（HEI-2015）、替代 HEI-2010（AHEI-2010）、替代地中海饮食（aMED）和停止高血压的饮食方法（DASH）评分来衡量饮食质量。多变量 Cox 模型估计了在 10 年随访时以及自基线以来的饮食指数与随后死亡率之间的关系。
四项指数中的所有四项的诊断后评分均与较低的死亡率相关：对于最高与最低四分位数，全因死亡率的风险比（HR）为 HEI-2015 的 0.74（95%CI 0.67-0.82），AHEI-2010 的 0.82（0.74-0.92），aMED 的 0.74（0.66-0.84），以及 DASH 的 0.82（0.74-0.91）。癌症死亡率的相应 HR 分别为 0.84（0.71-1.00）、0.85（0.71-1.00）、0.71（0.59-0.85）和 0.84（0.71-1.00）。与 10 年内评分稳定（<0.5SD 变化）相比，HEI-2015 的评分增加≥1SD 的 HR 为 0.87（0.79-0.97），而四项指数中评分降低≥1SD 的 HR 为 1.22 至 1.29。这些 HR 与无癌症参与者的 HR 相似。
在癌症幸存者中，诊断后高质量饮食与全因和癌症死亡率降低有关，其风险降低与无癌症参与者相当。
